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COVID-19 RESOURCES

Ethics Guidance and Resources on Covid-19

As communities across the world work to navigate the pandemic, The Hastings Center has assembled ethics resources for responding to novel coronavirus Covid-19. We are updating this hub throughout the crisis.

The Hastings Center developed resources for health care institutions and ethics services to support leadership and practice during the emergency:

Covid-19 Ethical Framework and Supplements

Ethical Framework for Health Care Institutions Responding to Novel Coronavirus SARS-CoV-2 (Covid-19); Guidelines for Institutional Ethics Services Responding to Covid-19, March 16, 2020, https://www.thehastingscenter.org/ethicalframeworkcovid19/.

Responding to Covid-19 as a Regional Public Health Challenge: Preliminary Guidelines for Regional Collaboration Involving Hospitals, April 29, 2020https://www.thehastingscenter.org/covid19-regional-ethics-guidelines/.

Access to Therapeutic and Palliative Drugs in the Context of Covid-19: Justice and the Relief of Suffering, July 16, 2020, https://www.thehastingscenter.org/access-to-therapeutic-and-palliative-drugs-in-the-context-of-covid-19/.

Ethical Challenges in the Middle Tier of Covid-19 Vaccine Allocation: Guidance for Organizational Decision-Making, January 15, 2021, https://www.thehastingscenter.org/ethical-challenges-in-the-middle-tier-of-covid-19-vaccine-allocation.

COVID-19: Supporting Ethical Care and Responding to Moral Distress in a Public Health Emergency. This powerpoint webinar is designed for use within a health care institution’s COVID-19 preparedness and response activities, supplementing public health, clinical practice, and ethical guidance.

The Hastings Center has produced a video that explains many of the issues in the pandemic for use by health care organizations and government agencies:

The Hastings Center is hosting a series, “Re-Opening the Nation,” online discussions of the ethical issues related to easing Covid-19 pandemic restrictions in the United States. The latest is: Vaccine Access, Vaccine Hesitancy.

We assembled a set of resources that address many of the ethical  issues raised about conducting human trials during the Covid-19 pandemic. 

From the Undocumented Patients project are ethics resources on the ways in which the pandemic has highlighted the vulnerabilities of low-wage immigrants to severe Covid-19 illness. 

The Center developed a pandemic ethics briefing, adapted from work by Alexandra Minna Stern and Howard Markel, that offers principles to guide implementation of quarantine, school closures, and social distancing.

Nearly 1,400  bioethicists and health leaders signed a letter to Congress and the White House, calling for Trump Administration to use the Defense Production Act against Covid-19.

You’ll find a many articles on Covid-19 from the Hastings Center Report and Bioethics Forum.

Below is a sampling of some of the earlier pieces:

On Federal action: A Hastings Center Report piece by Mildred Solomon,  Lawrence Gostin, and Matthew Wynia on the need for immediate, powerful, and sustained federal action regarding the scarcity of needed medical supplies: https://www.thehastingscenter.org/scarcity-in-the-covid-19-pandemic/

How to navigate the COVID-19 public health emergency legally and ethically, a Hastings Center Report piece by Lawrence O. Gostin, Eric A. Friedman, and Sarah A. Wetter: https://onlinelibrary.wiley.com/doi/full/10.1002/hast.1090 

On disability: A series of Bioethics Forum posts between Joseph Fins,  a member of the New York State Task Force on Life and the Law, and Ari Ne’eman, a disability activist. Follow their discussion: https://www.thehastingscenter.org/disabusing-the-disability-critique-of-the-new-york-state-task-force-report-on-ventilator-allocation/

More from Ari Ne’eman: Rationing and disability rights laws

On age and rationing of medical equipment: On Being an Elder in a Pandemic by Larry Churchill

A piece by Franklin Miller on why he supports age-related rationing of ventilators

On moving forward: How soon can those in areas affected by the virus consider a return to work, by Arthur Caplan: https://www.thehastingscenter.org/the-price-of-going-back-to-work-too-soon/ 

What steps to take after the COVID-19 infection curve flattens. The longer term response to the emergency, and the need for trust in public health, by Mark Rothstein: https://www.thehastingscenter.org/flattening-the-curve-then-what/

On public health: An argument that public health ethics is not primarily about the conflict between the interests of the few versus the greater good, but rather more about how we organize our society and how we relate to one another, by Sridhar Venkatapuram: https://www.thehastingscenter.org/covid-19-and-the-global-ethics-freefall/

An essay on the crisis of trust that argues that the primary culprits of Covid-19—institutional disinformation and concealment of information—have particularly eroded trust in international and government words and actions among the general public, by Alexandra Friedman: https://www.thehastingscenter.org/coronavirus-and-the-crisis-of-trust/

From China: In the second of two essays on transparency in fighting Coronavirus, Hastings Fellows in China, Ruipeng Lei and Renzong Qiu, give us an insider’s view on how authorities must make reforms. https://www.thehastingscenter.org/coronavirus-doctor-whistleblower/ 

In their first essay, they note that “transparency is a key principle” in addressing the coronavirus.
https://www.thehastingscenter.org/report-from-china-ethical-questions-on-the-response-to-the-coronavirus/

Other coronavirus and pandemic ethics resources:

On school openings: Johns Hopkins University eSchool+ InitiativeAnalysis of School Reopening Plans: https://equityschoolplus.jhu.edu/reopening-policy-tracker/

Johns Hopkins University: An Ethics Framework for the Covid-19 Reopening Process https://bioethics.jhu.edu/wp-content/uploads/2019/10/FINAL-SNF-Agora-Covid-19.pdf

CITI Program: Coronavirus (COVID-19) Resources to help the research community https://about.citiprogram.org/en/coronavirus-covid-19-resources/

World Health Organization: A Global Collaboration to Accelerate the Development, Production and Equitable Access to New COVID-19 diagnostics, therapeutics and vaccines https://www.who.int/who-documents-detail/access-to-covid-19-tools-(act)-accelerator

World Health Organization: Managing Ethical Issues in Infectious Disease Outbreaks
https://www.who.int/ethics/publications/infectious-disease-outbreaks/en/

Johns Hopkins University Covid-19 resource center: https://coronavirus.jhu.edu/

National Academy of Medicine: Duty to Plan: Health Care, Crisis Standards of Care, and Novel Coronavirus SARS-CoV-2 https://nam.edu/duty-to-plan-health-care-crisis-standards-of-care-and-novel-coronavirus-sars-cov-2/

AMA Journal of Ethics Covid-19 Ethics Resource Center https://journalofethics.ama-assn.org/covid-19-ethics-resource-center

University of Washington Medicine Covid-19 resources
https://covid-19.uwmedicine.org/Pages/default.aspx

The Nuffield Council: Guide to the ethics of surveillance and quarantine for novel coronavirus
https://www.nuffieldbioethics.org/news/guide-to-the-ethics-of-surveillance-and-quarantine-for-novel-coronavirus

News stories related to Covid-19:

How the Coronavirus May Force Doctors to Decide Who Can Live and Who Dies
https://www.nytimes.com/2020/03/12/opinion/coronavirus-hospital-shortage.html

What if Two COVID-19 Victims Need Ventilators and Just One Is Available? https://blogs.scientificamerican.com/observations/what-if-two-covid-19-victims-need-ventilators-and-just-one-is-available/

NEJM: History in a Crisis — Lessons for Covid-19 https://www.nejm.org/doi/full/10.1056/NEJMp2004361